WALKING V. CARRIAGE-EXERCISE. 29 The majority of people are wont to think too much of the other kinds of locomotive exercise,-as carriage-exercise, riding on horseback, and sailing,— and too little of walking. Carriage-exercise is of passive, rather than active character;-thanks to the perfection with which carriages are built, and the excellence of the springs on which they are hung, and the smoothness and hardness of our roads !—and is rather to be esteemed as a means of breathing the fresh and open air, than as a means of exercising the muscles of the body. The degree of exercise that is afforded by riding in a carriage, is indeed very trifling, and should never be relied on as a means of promoting the expenditure of the system. The invalid just arisen from the bed of sickness, is usually re-introduced into the open air by carriageexercise. This may not be improper if the carriage is a close one; but if it is an open vehicle, it is almost invariably to be condemned. The action of the heart and arteries being enfeebled by disease, the blood is driven languidly through the system; and the rapidly successive applications of cold air to the surface of the body, involved in the quick progress of the vehicle, -the system being, moreover, at the time, in a state almost that of absolute rest,-easily check the circulation of the blood through the vessels of the skin, by which the internal organs are apt to become unduly loaded with blood, congestion is risked, and a relapse into disease not unfrequently results. The degree of rapidity with which the air surrounding the body is changed, necessarily and greatly ministers to this risk. The air immediately surrounding the body getting warmed, if the individual is stationary, protects him somewhat from the colder air which is exterior to it. The less frequently this outer garment is changed, the less heat is taken from the body. The risk of the body being unduly chilled, is thus much less when the body is moved slowly through the air; and at the same time, in walking, no matter how gentle or how slow, some aid is afforded by the muscular contractions, to the weak and languidly-acting heart and blood-vessels, and risk from the chilling and depressing influence of the cold proportionably lessened. So firmly impressed am I with the importance of attention to this, that, if the strength is at all equal to it, I always advise my patients, when going out the first four or five times after an illness, to prefer gentle walking, even * It may be needless to say, that this depends on one of the simplest of chemical laws. If a wet cloth is hung in dry air, the more dry the air, the more quickly will the cloth lose its moisture by evaporation. If a ball, heated, say to 600°, is exposed to the cooling influence of air at the temperature of 60°, it will at first cool very rapidly; but the nearer its temperature approaches to that of the air which surrounds it, the more slowly will it lose its heat. Its temperature will very rapidly fall from 600° to 300°; less rapidly from 300° to 150°; and, every succeeding degree, its rate of cooling will be still slower and slower. The more quickly the air around it is changed,—in other words, the colder the air which surrounds it, the greater the difference between its temperature and that of the air,--the more quickly does it cool. The drier the air around a wet substance, the more quickly will that substance lose its moisture; the more damp the air, the less readily does it acquire or imbibe moisture, and the more slowly will the substance dry. WALKING V. CARRIAGE-EXERCISE. 31 if only a few yards, to any kind of less active exercise. Indeed, if the patient cannot walk thus much, and if the inability to do so is the effect of general debility, it may be well made a matter for thought and doubt as to the propriety of exposing the surface of the body to the open air at all. I may just mention here, although the remark would be better placed in a subsequent chapter, that, in the cases of such great debility, I have usually found much advantage in beginning with frictions of the surface, as with a flesh-brush,—at first gentle, and only used for a short time, then, used more vigorously, and for a longer period; following this up, after it has been persevered in for a longer or shorter time, according to the nature of the case, by sponging the surface with warm water, of course continuing the friction; afterwards, gradually lowering the temperature of the water, and increasing the degree of the friction. By such means, in a time often very short, and to a degree almost incredible, and, if prudently managed, with scarcely any check or interruption, the patient has recovered strength, and been enabled to walk more and more strongly, and prepared for exposure to the natural temperature of the air without risk. From what has now been said, another observation might be inferred; yet, perhaps, the mention of it may not be quite superfluous. The convalescent should never stand still when out of doors taking his exercise. It is a rule which should be impressed on the mind of every man just recovered from disease, on first committing his system to the ruder embraces of the open air-he ought always to keep moving. I have known many a distressing case of relapse into disease produced by the kind sympathy of friends, meeting an invalid, and stopping to inquire after his health. Riding on horseback, much less passive in its character than carriage-exercise, is an admirable auxiliary to walking, in the maintenance of health, and in securing the due expenditure of the system. It calls into action many muscles that are little used in walking, and is by so much subservient to the great purpose of exercising all the muscles. The peculiar movements of the body in riding, particularly the considerable use made of the abdominal muscles, has a marked stimulant effect on the functions of the viscera, and becomes often eminently useful in hepatic cases, and cases of sluggish action of the bowels. The remarkably good effect of horse-exercise, on the minor degrees and on the more chronic stage of muscular relaxation of the spinal column, evidently dependant on the gentle and equable use of important muscles of the back, which are otherwise little used, is generally known and fully admitted, and constitutes an important part of the treatment of such cases. It is impossible not to notice, moreover, in speaking of the advantages of horse-exercise, its exhilarating and diverting effect on the mind,— and the bracing effect on the vessels of the air passages and of the surface, of carrying the body so rapidly through the air; while undue depression of the circulation from this is prevented, by the degree of muscular exercise involved in the necessary movements. Sailing has long been lauded as an admirable remedy, in many, and especially in pulmonary, complaints; and its good effects have been attributed chiefly to the motion of the vessel. I have come, nolens volens, to a different conclusion. The air far out at sea is excessively pure, so far as being free from possible miasmatous matters; its temperature is remarkably uniform; its character is very peculiar, from being to such a degree charged with saline matters, and to the same degree with iodine, and probably other agents of equally powerful action on the human system; the mental excitement is very great, from the novelty of everything around the invalid, the bustle and cheerfulness of everything and every one he sees; the necessarily regular hours for the meals; the early going to bed; the separation from perhaps desponding friends; the removal from the ordinary sources of care and anxiety; the escape from heated rooms, and an atmosphere that is mephitic in an at least corresponding degree; the consequences, at least probable, of getting rid completely of all congestive disturbance, by the sea-sickness; the stimulant action of the saline and iodised atmosphere, and the consequent activity of the absorbents, — when all conjoined, are surely enough to explain any and every change in the state of the invalid, the altered relations of all the processes of his system, and any resulting improvement in his health, without having recourse to the mere movement of the ship |